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We examined the association of maternal stressful life events and social support with risks of birth defects using National Birth Defects Prevention Study data, a population-based case-control study.

Methods

We examined 7 stressful life events and 3 social support questions applicable to the periconceptional period, among mothers of 552 cases with neural tube defects (NTDs), 413 cleft palate (CP), 797 cleft lip +/− cleft palate (CLP), 189 d-transposition of the great arteries (dTGA), 311 tetralogy of Fallot (TOF), and 2,974 non-malformed controls. A stressful life events index equaled the sum of “yes” responses to the 7 questions. Social support questions were also summed to form an index. Data were analyzed using logistic regression to estimate odds ratios (OR) and 95% confidence intervals (CI), adjusted for maternal race-ethnicity, age, education, body mass index, smoking, drinking, and intake of vitamin supplements.

Results

Associations with the stress index tended to be higher with higher scores, but few 95% CIs excluded one. A 4-point increase in the index was moderately associated with NTDs (OR 1.5, 95% CI 1.1, 2.0) and CLP (OR 1.3, 95% CI 1.0–1.7). The social support index tended to be associated with reduced risk but most 95% CIs included one, with the exception of dTGA (OR for a score of three versus zero was 0.5, 95% CI 0.3–0.8).

Conclusions

Maternal periconceptional stressful life events, social support, and the two factors in combination were at most modestly, if at all, associated with risks of the studied birth defects.

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